PTSD: not just a military problem (with video)

Related

Kalina Christoff felt overwhelmed and pressured to accept medical procedures she didn’t want during the birth of her first child, a “dehumanizing” experience that led to anxiety and flashbacks. Jenn Baerg ended an abusive engagement, then had panic attacks and anxiety as she relived being molested by a family member during her teens and early 20s.

Christoff and Baerg are the other faces of post-traumatic stress disorder. Their struggles are less well known than PTSD among military personnel, war veterans and first responders, whose dramatic stories make good headlines. But studies show certain groups, like mothers with birth trauma, sexual assault victims and members of First Nations, often have higher rates of PTSD than the military.

Experts say nobody is immune to PTSD – all it takes is a traumatic event or a series of such events.

“When it comes to the actual diagnosis, there’s no difference (in the cause),” said Daniel Cox, an assistant professor in the counselling psychology program at the University of B.C. “An event is an event, whether it’s a firefight in the military or a car accident on the Burrard Bridge.”

Descriptions of people being traumatized by dramatic events have been documented since the times of the ancient Greeks, usually in connection with war. But the term post-traumatic stress disorder didn’t exist until 1980. That year it was included for the first time in the Diagnostic and Statistical Manual of Mental Disorders, the authoritative classification tool for psychiatrists. The definition has evolved over the years, with the latest change in 2013 adding sexual assault to the types of events that can trigger the disorder.

According to the American Psychiatric Association, PTSD occurs when a person experiences, witnesses, or is repeatedly exposed to “threatened death, serious injury or sexual violation.”

The Canadian Mental Health Association says of PTSD: “Something is traumatic when it is very frightening, overwhelming and causes a lot of distress.

“Trauma is often unexpected, and many people say that they felt powerless to stop or change the event. Traumatic events may include crimes, natural disasters, accidents, war or conflict, or other threats to life. It could be an event or situation that you experience yourself or something that happens to others, including loved ones.”

Both descriptions ring true for Christoff, an associate professor of psychology at the University of B.C., who was 35 when she gave birth to her first child at a Vancouver-area hospital in 2010. She said she was distressed, frightened and overwhelmed at the way she was treated by medical personnel, but worse, she felt powerless to stop the juggernaut of medical procedures that doctors seemed determined to perform.

She said the doctors expressed concern about her unborn child’s heartbeat and increasingly insisted on the necessity of using forceps in the birth, but refused to say what the heartbeat was or explain the risks of forceps. As the doctors grew increasingly angry at her questions and resistance, she said she finally consented out of fear about what would happen to her and her baby if she didn’t.

She regretted it immediately. “At the sound of that ‘OK,’ all 15 medical people in the room swarmed onto me, one person covered my raised legs with a blue sheet, so I couldn’t see anything of what was happening,” she recounted on a website she has started about birth trauma. “Because of the epidural, I couldn’t feel anything either. I didn’t see, hear or feel the birth of my child. No one told me he was born, and no one showed him to me.”

A later review of her medical records showed the baby’s heartbeat was fine and there was no need to use forceps, she said on her website, adding that an effort to seek an explanation and apology from one of the doctors involved was turned down.

But the damage was done.

“Both my baby and I sustained physical injuries from the forceps that we struggled with greatly during the first month after the birth. But much worse and longer lasting were the psychological injuries.”

She developed trauma and then severe PTSD. “I wasn’t traumatized because the birth itself was painful or scary, I was traumatized because of the way I was treated during the birth … it basically dehumanized me.”

For sexual abuse survivors like Baerg, who agreed to be named for this story, the trauma was suffered over a period of time in her younger years. PTSD emerged later, triggered by specific events.

For Baerg, that occurred in 2008, when she broke her engagement to a fiance who was both physically and verbally abusive.

She was 26 and breakup prompted her to reflect on the underlying issue of her abuse by a family member.

“This led to me having unhealthy relationships with men afterwards,” she said.

Baerg and Christoff each developed at least some of the symptoms of PTSD, which include nightmares, flashbacks, feelings of anger, anxiety and irritability, problems sleeping, drug and alcohol dependency and a general numbness.

Christoff was also troubled by people’s lack of sympathy. “People around me didn’t want to hear what I said,” she said, adding some would say: “Don’t complain, you have a healthy baby.”

“It’s a really difficult process because depending on the trauma, oftentimes the people who are traumatized might be encouraged not to remember.”

Baerg said her symptoms included anxiety, unpredictable panic attacks and sensitivity to physical contact. She recalled that something as innocuous as an ex-boyfriend touching her on the back once triggered an anxiety attack.

“It could even be harder for other people in my life,” she said of the disorder. “I can’t tell you when that hug will be not be OK.”

Another sexual assault survivor, Nicole Marcia, said her PTSD symptoms took the form of addictions.

“I was a very heavy drinker, a very heavy drug user, a very heavy smoker, I was engaged in a lot of sort of risky behaviours,” said Marcia, who was assaulted by a neighbour when she was in her early 20s. “All of which at the time I didn’t realize were very common methods of self-regulation for people who have experienced trauma.”

People with PTSD aren’t doomed. A variety of treatments are available, although their effectiveness varies according to the individual and the type of PTSD involved. Traditional treatments include counselling and medication, but alternative methods such as float tanks, holistic medicine, marijuana, ecstasy, meditation and yoga are also being tested.

It’s easiest to treat what experts call standard PTSD, which results from a single traumatic event. Complex PTSD, which develops after recurring events such as long-term sexual abuse of children, is trickier.

“The PTSD you have from a one-shot automobile accident is quite different than the PTSD that you get from repeated shocking events,” said psychologist Daria Shewchuk, who has an office in New Westminster, adding “simple straightforward uncomplicated PTSD is pretty easy to treat.”

Shewchuk uses counselling, including various clinical and therapeutic techniques, in her work.

UBC’s Cox said there are “wonderful” treatments for PTSD, noting that some people have devoted entire careers to developing them.

As for why some people involved in a traumatic event develop PTSD while others who experience the same thing do not, the U.S. National Institute of Mental Health says risk factors include how often people are exposed to dangerous events, their history of mental illness, how they seek support and help from family, whether they have a coping strategy, and how they respond to stress despite feeling fear. Other factors include pre-existing psychological conditions and whether an individual experienced childhood trauma or abuse.

While professional treatment for PTSD is available, some people find other ways of recovering from trauma.

Christoff educated herself on PTSD, then reached out to others with similar experiences. She started her own non-profit organization, Humanize Birth, which raises awareness about birth trauma by allowing women to share their stories on a website. On another website called Vancouver Birth Trauma, she tells her own story and offers information and resources on birth trauma and PTSD. Further action is in the works: Christoff plans to file a complaint to the B.C. ombudsperson’s office about her own and other women’s traumatic birth experiences.

“Part of my recovery was understanding how people process trauma in general … and the different kinds of trauma people can go through,” said Christoff.

Baerg had counselling, and later found great comfort in trauma-sensitive yoga, which she tried at Langara College in the spring of 2013. Trauma-sensitive yoga focuses on individuals’ comfort and respecting their space.

“I didn’t realize how impactful the gathering of survivors in a room is,” she said.

“You conceptually know from the statistics you’re not alone,” she said, noting that one in four women have been sexually assaulted, “but to have a visual representation in a room, there’s something supportive as well as sort of depressing, to realize that yes, that statistic does bear forward.”

Marcia, who is now a trauma-sensitive yoga teacher who instructs Baerg, said the practice helps regulate the body for those who feel disembodied after a traumatic event.

For Marcia, yoga was the way out of the turmoil caused by her sexual assault. Four years after the attack and 60 pounds heavier, she was sitting on the couch smoking a cigarette and watching Oprah Winfrey when she learned that Madonna was using Ashtanga yoga to stay in shape.

“Well, I thought, I could do yoga because it’s easy, and maybe I’ll look like Madonna and I won’t have to quit smoking,” said Marcia.

Over the next couple of years, as she practised yoga, she found her anxiety levels slowly decreasing.

“I noticed that the way I started to see myself in the world began to change,” said Marcia. “I went from someone who saw themselves very vulnerable in a very dangerous world to someone who was very strong and in a world where I had some chances and control.”

Interested in the relationship between yoga, trauma and addictions, she went back to school and completed her master’s in yoga therapy studies. She began teaching around Metro Vancouver, including at the Burnaby Centre for Mental Health and Addictions, where she discovered trauma-sensitive yoga.

That led to further studies at the Trauma Center at Justice Resource Institute in Brookline, Mass.

Traumatic events leading to PTSD often result in over-activity of the sympathetic nervous system, which control the body’s “fight or flight” response, she said.

“And that’s a lot of the reason people with PTSD turn to drugs and alcohol, because it helps them to regulate.”

Yoga offers a healthier alternative that helps control breathing, brings self-awareness and regulates the nervous system, she said.

Traumatic events and the ensuing PTSD are harrowing, life-altering experiences, but for those who complete treatment or find ways to cope, there can sometimes be positive outcomes.

These potential positives include a sense of new opportunities, closer relationships with others, an increased sense of personal strength, increased appreciation, and a deepening or change in spirituality, said UBC’s Cox.

Christoff said her experience changed her previously naive views of how the world works. She also felt a sense of personal growth, and the birth of her second child under better circumstances “made it right, in some sense, for me, personally.”

Her outreach work was a plus too. “Communicating with other survivors also gave me the sense of connectedness with others that I’d never had before.”

For Baerg, the positives were finding trauma-sensitive yoga and being able to talk about her experiences.

“I do feel a lot more comfortable with people, confident … a lot less anxiety,” said Baerg. “It does get better … life is so much bigger than being afraid.”

PTSD by the numbers

Serving in the military is stressful, but some other conditions and experiences are even more so. Here are what some studies have shown about post-traumatic stress disorder prevalence rates.

Canadian military: Depending on the data and research methods, rates range from about two to 10 per cent. A study in 2001 by Statistics Canada put rates at 2.3 per cent, while a 2011 background paper prepared by the Library of Parliament put rates as high as 10 per cent.

Childbirth: A 2012 study by McGill University put prevalence rates of PTSD following childbirth at between 7.6 per cent and 16.6 per cent.

Sexual assault: A 2008 study by the Anxiety Disorders Clinic at McMaster University Medical Centre put lifetime PTSD prevalence rates for women who experience a sexual assault as high as 26 per cent.

First Nations: A report in the Journal of Aboriginal Health in 2009 noted that a 2003 study on B.C. residential school survivors put PTSD rates as high 64 per cent.

Tyler Hooper is a recipient of the Langara College School of Journalism’s Read/Mercer Fellowship, given annually to four deserving students to produce a piece of journalism that will add to the dialogue on an issue of public concern. The award is named in honour of Province columnist Jeani Read and her playwright husband Michael Mercer, both of whom believed in helping young journalists begin their careers.

Comments

We encourage all readers to share their views on our articles and blog posts. We are committed to maintaining a lively but civil forum for discussion, so we ask you to avoid personal attacks, and please keep your comments relevant and respectful. If you encounter a comment that is abusive, click the "X" in the upper right corner of the comment box to report spam or abuse. We are using Facebook commenting. Visit our FAQ page for more information.

Share

PTSD: not just a military problem (with video)

Video

Today's News

Best of Postmedia

To steel himself for the year-long journey that began Wednesday, Jonathan Pitre has been going over the hard calculus that underpins his decision to pursue a high-risk, high-reward treatment in Minnesota

When he woke up in tears the morning after he had cried himself to sleep, Rohit Saxena knew what he had to do. Leaving his wife, Lesley, asleep in bed, Rohit went downstairs, opened his laptop and began to write. “They say your kids are your hearts outside your body,” he wrote. “I’ll always be […]

Almost Done!

Postmedia wants to improve your reading experience as well as share the best deals and promotions from our advertisers with you. The information below will be used to optimize the content and make ads across the network more relevant to you. You can always change the information you share with us by editing your profile.

By clicking "Create Account", I hearby grant permission to Postmedia to use my account information to create my account.

I also accept and agree to be bound by Postmedia's Terms and Conditions with respect to my use of the Site and I have read and understand Postmedia's Privacy Statement. I consent to the collection, use, maintenance, and disclosure of my information in accordance with the Postmedia's Privacy Policy.

Postmedia wants to improve your reading experience as well as share the best deals and promotions from our advertisers with you. The information below will be used to optimize the content and make ads across the network more relevant to you. You can always change the information you share with us by editing your profile.

By clicking "Create Account", I hearby grant permission to Postmedia to use my account information to create my account.

I also accept and agree to be bound by Postmedia's Terms and Conditions with respect to my use of the Site and I have read and understand Postmedia's Privacy Statement. I consent to the collection, use, maintenance, and disclosure of my information in accordance with the Postmedia's Privacy Policy.